Network media access control system for encouraging patient compliance with a treatment plan

ABSTRACT

A system and method for controlling patient access to an entertainment program to encourage a patient to comply with a treatment plan. The method includes the step of collecting compliance data from the patient. In one embodiment, the compliance data includes measurements of a physiological condition of the patient as well as patient answers to compliance questions. The method further includes the step of comparing the compliance data to evaluation criteria selected by a healthcare provider to determine if the patient is in compliance with the treatment plan. If the patient is in compliance, access is granted to the entertainment program. If the patient is not in compliance, access to the entertainment program is restricted. In the preferred embodiment, the method includes the additional steps of transmitting and displaying the patient&#39;s compliance data and compliance status to the healthcare provider.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 10/233,296 filed Aug. 30, 2002 which is a continuation-in-partapplication of U.S. patent application Ser. No. 09/304,447 filed May 3,1999 (abandoned) which is a continuation of U.S. patent application Ser.No. 08/771,951 filed Dec. 23, 1996, now U.S. Pat. No. 5,933,136. SaidU.S. patent application Ser. Nos. 10/233,296, 09/304,447 and 08/877,951are hereby incorporated by reference in their entirety.

FIELD OF THE INVENTION

The present invention relates generally to access control systems, andin particular to a system and method for controlling a patient's accessto an entertainment program to encourage the patient to comply with atreatment plan for a health condition.

BACKGROUND OF THE INVENTION

In recent years, an increasing number of healthcare providers haveinitiated outpatient or home healthcare programs for their patients. Thepotential benefits of these home healthcare programs are particularlygreat for chronically ill patients, such as those suffering fromdiabetes or asthma, who must treat their diseases on a daily basis.However, the success of these home healthcare programs is currentlylimited by each patient's initiative and motivation to comply with aprescribed treatment plan for his or her disease.

The most common reason a patient fails to comply with a treatment planis a lack of motivation to treat the disease when the disease is notcausing an immediately recognizable affect. The primary affect of mostdiseases is pain, and once the pain stops, many patients ignore thedisease until the pain returns. Of course, most healthcare issues can beaddressed much more effectively through prevention. The challenge is incommunicating the preventative concept to a patient in such a way thathe or she will be motivated and encouraged to comply with a prescribedtreatment plan.

A patient's lack of motivation to comply with a treatment plan alsolimits the ability of a healthcare provider to aid the patient intreating his or her disease. Many treatment plans require dailymonitoring of a physiological condition of the patient, such as bloodglucose levels in diabetes and peak flow rates in asthma. Since thepatients themselves monitor these conditions in outpatient programs, theprovider is often limited to learning each patient's status strictlythrough patient initiated events, such as an emergency visit or thedelivery of the patient's latest medical data. Even with the currentavailability of remote monitoring devices that store and transmitmedical data from a patient's home to a medical clinic, the providermust still wait for medical information whose arrival depends on thepatient's initiative.

As a result, the majority of the provider's time is spent with thepatients who are the most motivated and eager for treatment, while thegreatest medical needs remain with the unmotivated patients who do notvisit the provider or transmit their medical data. These unmotivatedpatients often develop urgent medical needs that could have beenprevented with proper plan compliance. Consequently, the cost oftreating their diseases is much higher than one might expect given thesophistication of current medical monitoring devices.

The prior art has not taught a restrictive access control system forencouraging a patient's compliance with a treatment plan. However,access control systems have been developed for controlling access totelevision programming based on the paying of a program fee or thedesired censorship of programs containing subject matter deemedunsuitable for all viewers. For example, U.S. Pat. No. 4,768,229 issuedto Benjamin et al. on Aug. 30, 1988 describes a restrictive accesscontrol system that includes a three-state switch for limitingtelevision tuning access to only designated channels. U.S. Pat. No.5,550,575 issued to West et al. on Aug. 27, 1996 discloses a viewerdiscretion television program control system which relies uponsuitability ratings and personal identification numbers of householdviewers to restrict television program access.

The systems described by Benjamin and West are not directed atmotivating a patient to comply with a treatment plan, nor do they haveany mechanism for monitoring a patient's compliance or for controllingprogram access in dependence upon the patient's compliance. Thus, noneof the prior art systems for controlling access to an entertainmentprogram encourage a patient to comply with a treatment plan, nor do theyprovide for remote monitoring of a patient's compliance.

OBJECTS AND ADVANTAGES OF THE INVENTION

In view of the above, it is an object of the present invention toprovide a system and method for controlling a patient's access to anentertainment program to encourage the patient to comply with aprescribed treatment plan. It is another object of the invention toprovide an access control system that encourages an unmotivated patientto monitor his or her condition and to transmit monitored data to ahealthcare provider.

These and other objects and advantages will become more apparent afterconsideration of the ensuing description and the accompanying drawings.

SUMMARY OF THE INVENTION

The invention presents a system and method for controlling patientaccess to an entertainment program to encourage a patient to comply witha treatment plan. The method includes the step of collecting in anaccess control system patient compliance data for determining if thepatient is in compliance with the treatment plan. In the preferredembodiment, the compliance data includes measurements of a physiologicalcondition of the patient as well as patient answers to compliancequestions.

The method further includes the step of storing in the access controlsystem compliance evaluation criteria selected by a healthcare provider.The compliance data is compared to the evaluation criteria to determineif the patient is in compliance with the treatment plan. If the patientis in compliance, access is granted to the entertainment program. If thepatient is not in compliance, access to the entertainment program isrestricted. In the preferred embodiment, the method includes theadditional step of displaying the patient's compliance data andcompliance status to the healthcare provider.

A preferred system for implementing the method of the invention includesa program display unit for displaying an entertainment program to thepatient. The system also includes a monitoring device for collectingpatient compliance data and a memory for storing the complianceevaluation criteria. An evaluation program compares the compliance datato the evaluation criteria to determine if the patient is in compliancewith the treatment plan. The system further includes an access controldevice in communication with the evaluation program for controllingaccess to the entertainment program in dependence upon the compliancestatus of the patient.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic block diagram of an access control systemaccording to the invention.

FIG. 2 is a sample evaluation criteria entry screen.

FIG. 3 is a schematic block diagram of a central server of the accesscontrol system of FIG. 1.

FIG. 4 is a schematic block diagram of an access control device of theaccess control system of FIG. 1.

FIG. 5 is a sample compliance questions script according to theinvention.

FIGS. 6-8 are sample messages appearing on the screen of a programdisplay unit of the access control system of FIG. 1.

FIG. 9 is a sample compliance data view appearing on the screen of aprovider workstation of the access control system of FIG. 1.

FIG. 10 is a flow chart illustrating steps included in a method of theinvention.

FIG. 11 is a schematic block diagram of another access control systemaccording to the invention.

FIG. 12 is a sample compliance questionnaire appearing on the screen ofa program display unit of the access control system of FIG. 11.

FIG. 13 is a flow chart illustrating steps included in another method ofthe invention.

FIG. 14 is a schematic block diagram of another access control systemaccording to the invention.

FIG. 15 is a schematic block diagram of another access control systemaccording to the invention.

FIG. 16 is a schematic block diagram of a web server, television set-topprocessor, and program display unit of the access control system of FIG.15.

FIG. 17 is a flow chart illustrating steps included in another method ofthe invention.

DESCRIPTION

The present invention is a system and method for controlling patientaccess to an entertainment program to encourage a patient to comply witha treatment plan. In the following detailed description, numerousspecific details are set forth in order to provide a thoroughunderstanding of the present invention. However, it will be apparent toone of ordinary skill in the art that these specific details need not beused to practice the invention. In other instances, well knownstructures, interfaces, and processes are not shown in detail to avoidunnecessarily obscuring the present invention.

A preferred embodiment of the invention is illustrated in FIGS. 1-9.FIG. 1 is a schematic block diagram of an access control system 10 forcontrolling patient access to an entertainment program. The systemincludes an entertainment program source 11 for broadcasting theentertainment program to a local cable operator headend 12. In thepreferred embodiment, program source 11 is a satellite televisionbroadcast system and the entertainment program is a television program.Headend 12 is connected via cable to a television set-top processor 14,in the preferred embodiment a cable converter box.

Set-top processor 14 is connected to a program display unit, such as atelevision 16, for displaying the television program to the patient.Specific techniques for establishing a cable television system in thismanner are well known in the art. Although set-top processor 14 isillustrated as a separate device in FIG. 1, those skilled in the artwill appreciate that processor 14 may be built into the television orbuilt into a video cassette recorder.

A central server 18 of a healthcare clinic is connected to headend 12such that server 18 is in communication with set-top processor 14through headend 12. A DTMF telephone 20 is connected to server 18 viastandard telephone lines. Telephone 20 is for collecting patient answersto compliance questions through an automated telephone call, as will beexplained below. A medical monitoring device 22 is connected totelephone 20 such that monitoring device 22 is in signal communicationwith server 18 through telephone 20.

Monitoring device 22 is capable of producing measurements of aphysiological condition of the patient and recording the measurementsfor later transmission to server 18. For example, for a diabeticpatient, device 22 is a blood glucose meter for measuring the patient'sblood glucose levels. For an asthmatic patient, device 22 is a peak flowmeter for measuring the patient's peak flow rates. Such monitoringdevices for recording and transmitting measurements are well known inthe art. Further, those skilled in the art will appreciate thatmonitoring device 22 need not be connected to server 18 throughtelephone 22. For example, in an alternative embodiment, monitoringdevice 22 is a wireless device having an RF transmitter for transmittingthe measurements to server 18 through an RF link. In another embodiment,device 22 is connected to server 18 through a separate modem connection.

A workstation 24 of a healthcare provider is networked to central server18. Workstation 24 is preferably a personal computer or network terminaland includes a display 27 and a selection device 29, such as a mouse orkeyboard. Workstation 24 is for entering in server 18 a treatment planspecification including compliance evaluation criteria for evaluating acompliance of the patient with the treatment plan.

FIG. 2 illustrates a treatment plan specification screen 31 as itappears on display 27 of workstation 24. Screen 31 includes a patientfield 26 for specifying a patient to be evaluated and a disease field 28for specifying the patient's disease. The preferred embodiment will bedescribed with reference to a patient who has diabetes, although it isto be understood that the system may be used with patients having anytype of health condition which requires a treatment plan.

Screen 31 includes check boxes 30 for selecting desired monitoringtypes. The monitoring types determine how the compliance of the patientwith the treatment plan is to be monitored. For example, a diabeticpatient may be monitored through a blood glucose meter, interactivetelephone questions, on-screen questions, or an interactive educationalprogram. This list of monitoring types represents a sample of thepresently preferred monitoring types and is not intended to limit thescope of the access control system.

Screen 31 also includes check boxes 32 for selecting evaluation criteriacorresponding to each monitoring type and data fields 34 for specifyingcriteria values. For example, FIG. 2 illustrates that the healthcareprovider has selected glucose monitoring for the patient. The healthcareprovider has also specified minimum glucose values, maximum glucosevalues, and a minimum number of glucose measurements the patient mustmake to comply with the treatment plan. The healthcare provider hasfurther specified telephone question monitoring for the patient and aminimum score to be achieved by the patient in answering the questions.Screen 31 further includes a monitoring interval field 36 for specifyinga desired monitoring interval, an OK button 38 for confirming theinformation entered in screen 31, and a CANCEL button 40 for cancelingthe information entered in screen 31.

FIG. 3 is a schematic block diagram illustrating server 18 in greaterdetail. Server 18 has a patient database 42 for storing planspecification 44 received from workstation 24 and measurements 50received from device 22. Database 42 is further capable of storingcompliance questions 46, patient answers 48, and compliance instructions52. Server 18 includes a call processing application 54 for placing anautomated telephone call to the patient. Application 54 is designed toask compliance questions 46 and receive patient answers 48 throughtelephone 20 and digital/tone signal converter 58. A compliancequestions script 82 containing sample compliance questions is shown inFIG. 5. The programming of an automated call processing application toperform these functions is well known in the art.

Server 18 further includes a data view program 61. Data view program 61is designed to display device measurements 50 and a compliance status ofthe patient on the display of workstation 24. FIG. 9 shows a sample dataview 90 produced by the data view program illustrating a diabeticpatient's compliance data. Data view 90 includes a graph of the devicemeasurements, as well as a compliance status field 92 indicating thecurrent compliance status of the patient. Specific techniques forcreating a data view program to display data in this manner are wellknown in the art.

Referring again to FIG. 3, server 18 additionally includes an evaluationprogram 56. Evaluation program 56 is designed to compare the compliancedata received in database 42 to the evaluation criteria specified inplan specification 44 to determine a compliance status of the patient.Evaluation program 56 also includes program logic for performing variouscontrol functions described in the operation section below. Specifictechniques for creating an evaluation program to perform the controlfunctions described are well known in the art.

Server 18 is connected to a data transmitter/receiver 60 fortransmitting data to headend 12 and receiving data from headend 12through a data link 62. It will be apparent to one skilled in the artthat data link 62 may comprise a telephone line, radio signal link,satellite link, or any other suitable link for transmitting data betweena server and a cable headend.

FIG. 4 is a schematic block diagram illustrating the interaction ofheadend 12, set-top processor 14, and television 16 in greater detail.Headend 12 is designed to receive television program signals fromprogram source 11 and relay the program signals to set-top processor 14through a signal path 66. Headend 12 is further designed to receive datasignals from server 12 through link 62 and relay the data signals toset-top processor 14 through a signal path 64. It will be apparent toone skilled in the art that signal paths 64 and 66 may be located in thesame transmission cable connecting set-top processor 14 to headend 12.

Set-top processor 14 has a television tuner 72 for receiving thetelevision program signals from signal path 66. Set-top processor 14also has a data receiver 68 for receiving the data signals from signalpath 64 and for relaying the data signals to a microprocessor 70. Amemory 74 and a video text generator 76 are connected to microprocessor70. Set-top processor 14 also includes a switch 78 controlled bymicroprocessor 70. The switch has a first position for connectinggenerator 76 to television 16 and a second position for connecting tuner72 to television 16. Generator 76 is designed to generate text messagesfor display on television 16. Sample text messages are shown in FIGS.6-8 and will be explained in detail below.

The operation of the preferred embodiment is illustrated in FIG. 10.FIG. 10 is a flow chart showing a preferred method of using accesscontrol system 10 to encourage the patient to comply with the treatmentplan. In step 200, plan specification 44 is selected by a healthcareprovider and stored in database 42. The healthcare provider stores planspecification 44 including the selected evaluation criteria in database42 by completing screen 31 on workstation 24 and pressing OK button 38,as shown in FIG. 2.

Next, evaluation program 56 determines if the healthcare providerspecified telephone monitoring for the patient, decision step 202. Iftelephone monitoring is not specified, evaluation program 56 proceeds todecision step 208. If telephone monitoring is specified, call processingapplication 54 completes an automated telephone call to the patient,step 204. Call processing application 54 places the call to the patientthrough telephone 20 and asks compliance questions 46. The patientanswers the questions using the touch tone key pad of telephone 20.Patient answers 48 are received through converter 58 and stored indatabase 42. Next, evaluation program 56 compares patient answers 48 tothe evaluation criteria specified in plan specification 44, step 206.

As shown in FIG. 2, the healthcare provider specified that thecompliance questions need only be completed by the patient to be incompliance. In an alternative embodiment, the healthcare provider mayenter a minimum numeric score the patient must achieve to be incompliance. In this embodiment, the evaluation program includes programlogic for scoring the patient answers and for comparing the patient'sscore to the minimum score specified by the healthcare provider.

The advantage of merely requiring the patient to provide completeanswers to the compliance questions is that it removes the temptationfor the patient to be untruthful in his or her answers in an effort toachieve a false compliance status. It is a significant advance inhealthcare to motivate a patient to supply information to a healthcareprovider on a regular basis, even if the information indicates that thepatient is having difficulty with the treatment plan. Thus, in thepreferred embodiment, the patient is deemed to be in compliance if thepatient provides complete answers to the compliance questions.

Following step 206, evaluation program 56 proceeds to decision step 208,determining if the healthcare provider specified device monitoring forthe patient. If device monitoring is not specified, evaluation program56 proceeds to decision step 216. If device monitoring is specified,evaluation program 56 proceeds to step 210, prompting the patient totransmit measurements 50 to server 18.

To prompt the patient, server 18 transmits prompt signals to set-topprocessor 14 through link 62 and path 64, as shown in FIG. 4. The promptsignals include prompt data used by text generator 76 to generate aprompting message on television 16. Microprocessor 70 places switch 78in its first position to connect text generator 76 to television 16.Generator 76 then produces a prompt message 84 which is displayed ontelevision 16, as shown in FIG. 6.

Upon reading the prompt, the patient transmits measurements 50 frommonitoring device 22 to central server 18, step 212, and themeasurements are stored in database 42. Evaluation program 56 thencompares the measurements to the criteria values specified by thehealthcare provider, step 214. In step 216, evaluation program 56determine a compliance status of the patient based on the comparison ofmeasurements 50 and patient answers 48 to the corresponding criteriavalues specified by the healthcare provider. If the patient is incompliance, a compliance message is displayed to the patient, step 218,and access is granted to the television program, step 220.

To display the compliance message and grant access to the televisionprogram, server 18 transmits compliance message signals and a grantaccess control signal to set-top processor 14 through link 62 and path64, as illustrated in FIG. 4. The compliance message signals includecompliance message data used by text generator 76 to generate thecompliance message on television 16. Microprocessor 70 places switch 78in its first position to connect text generator 76 to television 16.Generator 76 then produces a compliance message 86 which is displayed ontelevision 16, as shown in FIG. 7. The grant access control signalinstructs microprocessor 70 to place switch 78 in its second positionfollowing the display of message 86. In its second position, switch 78connects tuner 72 to television 16 so that the patient has access to thetelevision program.

If the patient is not in compliance, an instructional message isdisplayed to the patient, step 222, and access is restricted to thetelevision program, step 224. To display the instructional message andrestrict access to the television program, server 18 transmitsinstruction signals and a restrict access control signal to set-topprocessor 14. The instruction signals include instructional message dataused by text generator 76 to generate the instructional message ontelevision 16. Microprocessor 70 places switch 78 in its first positionto connect text generator 76 to television 16. Generator 76 thenproduces the instructional message which is displayed on television 16.

FIG. 8 shows a sample instructional message 88 as it appears ontelevision 16. Message 88 contains an explanation of why access to theentertainment program is being restricted and compliance instructionswhich include a description of an action the patient must perform tosatisfy the evaluation criteria. The restrict access control signalinstructs microprocessor 70 to maintain switch 78 in its first positionfollowing the display of message 88. In its first position, switch 78disconnects tuner 72 from television 16 so that the patient is deniedaccess to the television program.

In step 226, the compliance data and compliance status of the patientare displayed to the healthcare provider in compliance data view 90, asshown in FIG. 9. Next, the health care provider determines if he or shewishes to modify the patient's treatment plan specification, decisionstep 228. If the healthcare provider desires to modify the planspecification, he or she returns to step 200, storing the planspecification in the database. If the healthcare provider does notdesire to modify the plan specification, evaluation program 56 returnsto step 202 and continues the monitoring loop at the specifiedmonitoring interval.

FIGS. 11-12 illustrate a second embodiment of the invention. The secondembodiment differs from the preferred embodiment in that the evaluationprogram is stored and executed in the set-top processor rather than theserver. Thus, in the second embodiment, the compliance status of thepatient is determined by the set-top processor rather than the server.

Referring to FIG. 11, an access control system 85 includes a set-topprocessor 14 having a microprocessor 70 and a memory 74. Memory 74stores the evaluation program to be executed by microprocessor 70 todetermine a compliance status of the patient and to perform the controlfunctions described in the operation section below. The programming of amicroprocessor to perform the functions described is well known in theart. Memory 74 further stores compliance instructions for the patientand prompt data used by text generator 76 to produce prompting messagesfor display on television 16.

The second embodiment also differs from the preferred embodiment in thatthe patient is asked compliance questions through television 16 ratherthan through an automated telephone call. System 85 includes a userinput device, such as remote control 98, for entering patient answers tothe compliance questions. Remote control 98 is preferably a standardinfrared remote for generating infrared signals 100. Set-top processor14 has a control receiver 102 connected to microprocessor 70 forreceiving infrared signals 100 from remote control 98.

The second embodiment further differs from the preferred embodiment inthat monitoring device 22 is connected to set-top processor 14 ratherthan server 18. Set-top processor 14 has a data port 96 connected tomemory 74 through microprocessor 70. Device 22 is connected to data port96 through a connection cord 69 such that measurements 50 may beuploaded to microprocessor 70 for storage in memory 74. Set-topprocessor 14 further includes a data receiver/transmitter 67 forreceiving data input signals from headend 12 through signal path 64 andfor transmitting data output signals to headend 12 through a signal path94. Signal paths 64 and 94 are preferably located in the sametransmission cable connecting set-top processor 14 to headend 12.

The operation of the second embodiment is shown in FIG. 13. FIG. 13 is aflow chart showing a preferred method of using access control system 85to encourage a patient to comply with a treatment plan. In step 300,plan specification 44 and compliance questions 46 are transmitted fromserver 18 to set-top processor 14 through link 62 and signal path 64.Plan specification 44 and compliance questions 46 are received byreceiver/transmitter 67 and stored in memory 74. In step 302, textgenerator 76 produces a compliance questionnaire which is displayed tothe patient on television 16. FIG. 12 illustrates a sample compliancequestionnaire 104 containing compliance questions 46.

The patient enters answers 48 to compliance questions 46 using remotecontrol 98, step 304. The patient answers are received through controlreceiver 102 and stored in memory 74. Microprocessor 70 compares thepatient answers to the criteria specified in plan specification 44, step306. Next, microprocessor 70 determines if plan specification 44specifies device monitoring for the patient, decision step 308. Ifdevice monitoring is not specified, microprocessor 70 proceeds todecision step 316. If device monitoring is specified, microprocessor 70proceeds to step 310, prompting the patient to upload devicemeasurements 50 to set-top processor 14.

To prompt the patient, text generator 76 generates a prompt messagewhich is displayed on television 16 asking the patient to uploadmeasurements 50 to set-top processor 14. The patient then uploads themeasurements from monitoring device 22 to set-top processor 14 throughcord 69, step 312. The measurements are received through data port 96and stored in memory 74.

In step 314, microprocessor 70 compares the measurements to the criteriavalues specified in plan specification 44. In step 316, microprocessor70 determines a compliance status of the patient based on the comparisonof measurements 50 and patient answers 48 to the corresponding criteriavalues specified in plan specification 44, decision step 316. If thepatient is in compliance, access is granted to the desired televisionprogram, step 318. To grant access, microprocessor 70 positions switch78 in its second position to connect tuner 72 to television 16.Microprocessor 70 then proceeds to step 324.

If the patient is not in compliance, access is restricted to thetelevision program, step 320, and the compliance instructions aredisplayed to the patient on television 16, step 324. To restrict accessto the television program and display the compliance instructions,microprocessor 70 places switch 78 in its first position to connect textgenerator 76 to television 16.

Generator 76 then produces an instructional message which is displayedon television 16. As described in the preferred embodiment above, themessage contains an explanation of why access to the entertainmentprogram is being restricted and compliance instructions which include adescription of an action the patient must perform to satisfy theevaluation criteria. Microprocessor 70 maintains switch 78 in its firstposition following the display of the message so that the patient isdenied access to the television program.

In step 324, the device measurements, patient answers, and compliancestatus of the patient are transmitted from set-top processor 14 toserver 18 through signal path 94 and link 62. The compliance status,measurements, and patient answers are stored in database 42. Theremaining operation of the second embodiment is analogous to theoperation of the preferred embodiment described above.

Although the second embodiment has been described with the centralserver communicating with the set-top processor through the cableheadend, it is obvious that the central server could also be connecteddirectly to the set-top processor through telephone lines, or asimilarly suitable network connection. Communication through the cableheadend is presently preferred so that the set-top processor need onlyhave one network connection, but it is anticipated that the centralserver may be in direct communication with the set-top processor.

FIG. 14 shows a third embodiment of the invention. The third embodimentis similar in design and operation to the second embodiment describedabove. However, the third embodiment differs from the second embodimentin that the central server and workstation are replaced by a singlehealthcare provider computer. The third embodiment also differs from thesecond embodiment in that data is transferred between the set-topprocessor and provider computer using a data storage card rather thannetwork connections.

As shown in FIG. 14, an access control system 115 includes a healthcareprovider computer 25, preferably a personal computer. Computer 25includes patient database 42 for storing plan specification 44,compliance questions 46, patient answers 48, and device measurements 50.Computer 25 also includes a data card reader/writer 124 for receiving adata storage card 128, such as a smart card or computer disk.Reader/writer 24 is designed to read data from card 128 and write datato card 128. Set-top processor 14 has a corresponding card reader/writer126 for reading data from card 128 and writing data to card 128.

The operation of the third embodiment is analogous to the operation ofthe second embodiment previously described with reference to FIG. 13.The operation of the third embodiment differs only in step 300,transmitting plan specification 44 and compliance questions 46 toset-top processor 14, and step 324, transmitting the compliance data todatabase 42. In the third embodiment, step 300 is performed by writingplan specification 44 and compliance questions 46 on card 128 usingreader/writer 124 of provider computer 25. The healthcare providertypically performs this step during a patient office visit. The patientthen takes card 128 to set-top processor 14 and inserts card 128 inreader/writer 126. Plan specification 44 and compliance questions 46 arethen read and stored in memory 74.

Similarly, step 302 is performed by writing patient answers 48 andmeasurements 50 on card 128 using reader/writer 126 of set-top processor14. The patient then takes card 128 to the healthcare provider. Thehealthcare provider inserts card 128 in reader/writer 124. Patientanswers 48 and measurements 50 are then read and stored in database 42.Other than the differences described, the operation of the thirdembodiment is the same as the operation of the second embodimentdescribed above.

A fourth embodiment of the invention is illustrated in FIGS. 15-16. Thefourth embodiment differs from the preferred embodiment in that theentertainment program source is a world wide web server and theentertainment program is a web entertainment program. Referring to FIG.15, an access control system 105 includes a web server 106 connected toa web television set-top processor 15. Set-top processor 15 is connectedto television 16 such that television 16 displays to the patient worldwide web programs accessed through set-top processor 15. Workstation 24is networked to web server 106 for entering in web server 106 planspecification 44.

The fourth embodiment also differs from the preferred embodiment in thatthe compliance data collected from the patient includes patientresponses to an interactive educational program. Referring to FIG. 16,web server 106 includes an interactive educational program 114 forteaching the patient proper treatment of his or her health condition andfor asking the patient questions about the information presented. Suchinteractive educational programs for teaching a patient about a healthcondition are well known in the art. Web server 106 also includes apatient database 42 for storing plan specification 44 received fromworkstation 24 and patient responses 120 to program 114.

Web server 106 further includes a router 118 for routing patient accessbetween educational program 114 and a web entertainment program 116. Webserver 106 additionally includes evaluation program 56. In thisembodiment, evaluation program 56 is designed to compare patientresponses 120 received in database 42 to the evaluation criteriaspecified in plan specification 44 to determine a compliance status ofthe patient. Evaluation program 56 also includes program logic forperforming various control functions described in the operation sectionbelow. Specific techniques for creating an evaluation program to performthe control functions described are well known in the art.

Set-top processor 15 includes a web browser program 110 stored in memory74. Set-top processor 15 also includes a modem 108. Microprocessor 70 isconnected to memory 74 and modem 108 to execute browser program 110 andaccess web server 106 through internet communication network 112.Set-top processor 15 also includes control receiver 102 connected tomicroprocessor 70 for receiving infrared signals 100 from remote control98.

The operation of the fourth embodiment is shown in FIG. 17. FIG. 17 is aflow chart showing a preferred method of using system 105 to controlpatient access to entertainment program 116. In step 400, planspecification 44 is stored in web server 106 through workstation 24.Next, the patient accesses web server 106 through set-top processor 15and network 112. Router 118 initially routes the patient to educationalprogram 114 and restricts access to entertainment program 116.Educational program 114 is displayed on television 16, step 402.

As the patient interacts with educational program 114, he or she enterspatient responses 120 using remote control 98. Patient responses 120 arereceived by web server 106 and stored in database 42, step 404. Next,evaluation program 56 compares the patient responses to the criteriaspecified in plan specification 44, step 406. Evaluation program 56 thendetermines if the patient is in compliance, decision step 408. If thepatient is in compliance, access is granted to entertainment program116, step 410. To grant access, evaluation program 56 instructs router118 to route the patient to entertainment program 116.

If the patient is not in compliance, access is restricted toentertainment program 116, step 412. Router 118 continues to restrictthe patient's access to entertainment program 116 until evaluationprogram 56 determines that the patient is in compliance. The remainingoperation of the fourth embodiment is analogous to the operation of thepreferred embodiment described above.

SUMMARY, RAMIFICATIONS, AND SCOPE

Although the above description contains many specificities, these shouldnot be construed as limitations on the scope of the invention but merelyas illustrations of some of the presently preferred embodiments. Manyother embodiments of the invention are possible. For example, theinvention is not limited to controlling patient access to a televisionprogram or world wide web program. The method of the invention isequally effective for controlling access to any entertainment programwhich may be broadcast or otherwise transmitted to consumers. Inembodiments that control access to television programs, the invention isnot limited to cable television systems. It is anticipated that themethod of the invention will be used with direct broadcast satellitesystems or any other system for broadcasting television programming.

Additionally, the set-top processor described is exemplary of just onepossible embodiment of the invention. Those skilled in the art willappreciate that many other types of processors may be used to restrictaccess to an entertainment program. For example, an alternativeembodiment includes a processor having a signal decoder which isselectively enabled and disabled by an entertainment broadcast company.In this embodiment, the broadcast company receives the patient'scompliance status directly from the central server or healthcareprovider and grants or restricts access to its broadcast entertainmentprograms by selectively enabling and disabling the processor.

Further, the preferred embodiment describes the use of medicalmonitoring devices and telephones for collecting compliance data fromthe patient. However, many other methods of collecting data from apatient are possible in alternative embodiments. For example, thepatient could be provided with an electronic logbook and modem fortransmitting compliance data via telephone lines. In another embodiment,the patient is provided with a paper based logbook and an automatedreader for digitizing and transmitting the compliance data to thepatient database. Alternatively, the patient could mail or fax thecompliance data to the healthcare provider for entry into the database.

The compliance questions and compliance instructions illustrated areexemplary of just one possible embodiment of the invention. Many otherquestions and instructions may be displayed or telephoned to patients inalternative embodiments. Additionally, the preferred embodimentdescribes a system and method for encouraging patients having diabetes.However, the invention is not limited to diabetic patients. The systemand method described are equally effective for patients having asthma,hypertension, cardiovascular disease, eating disorders, HIV, mentalhealth disorders, or any other health condition requiring a treatmentplan.

Therefore, the scope of the invention should be determined not by theexamples given but by the appended claims and their legal equivalents.

1. A system for interactively communicating with an individual,comprising: a server; a microprocessor based unit remotely located fromsaid server and in communication with said server; said microprocessorbased unit being suitable for receipt of a first information from saidserver, said first information including health related information; aninput device in communication with said microprocessor based unit; saidinput device being suitable for receiving a response from a user of saidinput device to said first information and communicating said responseto said microprocessor based unit; and a display unit coupled to saidmicroprocessor based unit, wherein said display unit displays said firstinformation to said user, wherein said microprocessor based unitevaluates said response from said user and provides a second informationto said user for display on said display unit, wherein said secondinformation includes a treatment plan specification based upon saidhealth related information and said response of said user, wherein saidmicroprocessor based unit restricts user access to an entertainmentprogram when the microprocessor based unit determines via the evaluationthat the user response is non-compliant with said first information. 2.The system as claimed in claim 1, further comprising a computer remotelylocated from said server in communication with said server.
 3. Thesystem as claimed in claim 2, wherein said computer communicates saidfirst information to said server.
 4. The system as claimed in claim 1,wherein said server is provided said first information for communicationto said microprocessor based unit.
 5. The system as claimed in claim 1,wherein said first information is a set of questions.
 6. The system asclaimed in claim 1, wherein said first information is a set ofinstructions.
 7. The system as claimed in claim 1, wherein said serveris a web server.
 8. The system as claimed in claim 1, wherein said inputdevice is a remote control.
 9. The system as claimed in claim 1, whereinsaid display unit is a television.
 10. The system as claimed in claim 1,wherein said microprocessor based unit, said display unit and said inputdevice are integrated within a single housing.
 11. The system as claimedin claim 1, wherein said microprocessor based unit communicates withsaid server through a headend.
 12. The system as claimed in claim 1,further comprising a monitoring device in communication with saidserver.
 13. The system as claimed in claim 12, wherein said monitoringdevice measures a health condition of said user.
 14. The system asclaimed in claim 12, wherein said monitoring device measures vital signsof said user.
 15. The system as claimed in claim 12, wherein saidmonitoring device communicates with said server through a radiofrequency link.
 16. The system as claimed in claim 12, wherein saidmonitoring device communicates with said server through a modem.
 17. Thesystem as claimed in claim 12, wherein said monitoring devicecommunicates with said server through a telephone line.
 18. The systemas claimed in claim 1, further comprising a monitoring device incommunication with said microprocessor based unit.
 19. The system asclaimed in claim 18, wherein said monitoring device measures a healthcondition of said user.
 20. The system as claimed in claim 18, whereinsaid monitoring device measures vital signs of said user.
 21. The systemas claimed in claim 18, wherein said monitoring device communicates withsaid microprocessor based unit through a radio frequency link.
 22. Thesystem as claimed in claim 18, wherein said monitoring devicecommunicates with said microprocessor based unit through a modem. 23.The system as claimed in claim 18, wherein said monitoring devicecommunicates with said microprocessor based unit through a telephoneline.
 24. The system as claimed in claim 1, wherein said microprocessorbased unit includes a web browser and a modem.
 25. The system as claimedin claim 1, wherein said microprocessor based unit and said servercommunicate across internet.
 26. A method, executable by amicroprocessor based unit, for interactively communicating with anindividual, comprising: receiving a first information from aremotely-located server, said first information including a firsttreatment plan specification and compliance questions; based upon thereceived first information, generating a compliance questionnaire via atext generator of the microprocessor based unit; transferring saidcompliance questionnaire to a display unit for display of saidcompliance questionnaire to a user; receiving a response from said userregarding said compliance questionnaire through an input device;comparing the response to criteria specified in the first treatment planspecification; determining if the first treatment plan specificationspecifies device monitoring for the patient; when the first treatmentplan specification specifies device monitoring for the patient, saidmethod includes: generating a prompt message via the text generator ofthe microprocessor based unit; transferring said prompt message to thedisplay unit for display of said prompt message to the user, said promptmessage for prompting the patient to upload device measurements to themicroprocessor based unit; receiving said device measurements; comparingthe received device measurements to criteria specified in the firsttreatment plan specification; determining a compliance status of theuser relative to the first treatment plan specification based on thecomparison of the response and the device measurements to the criteriaof the first treatment plan specification; when the first treatment planspecification does not specify device monitoring for the patient, saidmethod includes: determining a compliance status of the user relative tothe first treatment plan specification based on the comparison of theresponse to the criteria of the first treatment plan specification; whenthe compliance status is determined by the microprocessor based unit asbeing non-compliant, said method includes: restricting user access to atelevision program; generating a second information; and transferringsaid second information to said display unit for display of said secondinformation to said user, wherein said second information includes asecond treatment plan specification based upon said response of saiduser; and when the compliance status is determined by the microprocessorbased unit as being compliant, said method includes: granting useraccess to the television program.
 27. A system for interactivelycommunicating with an individual, comprising: a server; a set-top boxmicroprocessor based unit remotely located from said server and incommunication with said server; said set-top box microprocessor basedunit being suitable for receipt of a first information from said server,said first information including health related information; a remotecontrol device in communication with said set-top box microprocessorbased unit; said remote control device being suitable for receiving aresponse from a user of said remote control device to said firstinformation and communicating said response to said set-top boxmicroprocessor based unit; and a television coupled to said set-top boxmicroprocessor based unit, wherein said television displays said firstinformation to said user, wherein said set-top box microprocessor basedunit evaluates said response from said user and provides a secondinformation to said user for display on said television, wherein saidsecond information includes a treatment plan specification based uponsaid health related information and said response of said user, wherein,when said microprocessor based unit determines via the evaluation thatthe user response is non-compliant with said first information, saidmicroprocessor based unit restricts user access to a television programvia the television by positioning a switch of the microprocessor basedunit to connect a text generator to the television.
 28. The system asclaimed in claim 27, further comprising a computer remotely located fromsaid server in communication with said server.
 29. The system as claimedin claim 28, wherein said computer communicates said first informationto said server.
 30. The system as claimed in claim 27, wherein saidserver is provided said first information for communication to saidset-top box microprocessor based unit.
 31. The system as claimed inclaim 27, wherein said first information is a set of questions.
 32. Thesystem as claimed in claim 27, wherein said first information is a setof instructions.
 33. The system as claimed in claim 27, wherein saidserver is a web server.
 34. The system as claimed in claim 27, whereinsaid set-top box microprocessor based unit and said television areintegrated within a single housing.
 35. The system as claimed in claim27, wherein said set-top box microprocessor based unit communicates withsaid server through a headend.
 36. The system as claimed in claim 27,further comprising a monitoring device in communication with saidserver.
 37. The system as claimed in claim 36, wherein said monitoringdevice measures a health condition of said user.
 38. The system asclaimed in claim 36, wherein said monitoring device measures vital signsof said user.
 39. The system as claimed in claim 36, wherein saidmonitoring device communicates with said server through a radiofrequency link.
 40. The system as claimed in claim 36, wherein saidmonitoring device communicates with said server through a modem.
 41. Thesystem as claimed in claim 36, wherein said monitoring devicecommunicates with said server through a telephone line.
 42. The systemas claimed in claim 27, further comprising a monitoring device incommunication with said set-top box microprocessor based unit.
 43. Thesystem as claimed in claim 42, wherein said monitoring device measures ahealth condition of said user.
 44. The system as claimed in claim 42,wherein said monitoring device measures vital signs of said user. 45.The system as claimed in claim 42, wherein said monitoring devicecommunicates with said set-top box microprocessor based unit through aradio frequency link.
 46. The system as claimed in claim 42, whereinsaid monitoring device communicates with said set-top box microprocessorbased unit through a modem.
 47. The system as claimed in claim 42,wherein said monitoring device communicates with said set-top boxmicroprocessor based unit through a telephone line.
 48. The system asclaimed in claim 27, wherein said set-top box microprocessor based unitincludes a web browser and a modem.
 49. The system as claimed in claim27, wherein said set-top box microprocessor based unit and said servercommunicate across internet.